High-level Conference on Health Equity opens – achieve, accelerate and influence

Setting the scene for the forthcoming days, the Dance Theatre Ljubljana, under the choreography of Rosana Hribar, performed a modern dance routine that brought the conference themes of “achieve, accelerate and influence” vibrantly to life. The dance emphasized that peace is the underlying condition that must be consistently cultivated and nurtured for all of us and society to thrive and prosper.

Conference opening

Opening the proceedings, Mr Aleš Šabeder, Minister of Health, Slovenia, welcomed over 200 delegates spanning a range of policy sectors and agencies, from academia, government and civil society, in 36 countries across the WHO European Region. Noting that Slovenia has a long tradition of focusing on health equity dating back to a commitment to health for all from the 1920s, the Minister recognized that recent and growing health inequities require innovative approaches. He explained that Slovenia works across sectors, gathering local and regional partners to address health inequities. In concluding, Minister Šabeder underlined his commitment to implementing the 2030 Agenda for Sustainable Development, ensuring that no one is left behind, by prioritizing access to health services, including screening, prevention and promotion initiatives for the most vulnerable.

Via video, Dr Zsuzsanna Jakab, WHO Deputy Director-General and WHO Regional Director for Europe, acknowledged the challenges in reducing health inequities, but sounded an optimistic note, “We are here today to share good news. We know through experience that reducing health inequities is politically doable; we have evidence that it is economically viable; and we now have the authority to act thanks to public support”.

How equity is essential to achieving the Sustainable Development Goals (SDGs) was a theme picked up by Dr Piroska Östlin, Acting WHO Regional Director for Europe, in her opening address. “Whilst our attention and hard work across the Region has meant we’re on track to achieve many SDGs, we are struggling with one important one that will help us to achieve health equity. SDG 10, reducing inequity, is the only SDG which is not improving in our Region. To achieve SDG 10, indeed to achieve all the SDGs, we need concrete and tailored national and local actions, to bring positive change to the lives and health of all people in our Region,” she said.

Health Equity Status Report Initiative and policy tool

Ms Chris Brown, Head of the WHO European Office for Investment for Health and Development then walked delegates through some of the initial findings of the Health Equity Status Report Initiative. Efforts to address health inequities have been hampered by misconceptions that the issues involved are too complex, and actions have no political support, are not achievable, they cannot be prioritized, are not based on data and are unaccountable. The health equity initiative was established to set a baseline to measure progress, understand what can be done better, demystify the conditions affecting equity and build a stronger transnational political voice, explained Ms Brown.

Although almost a billion people in the WHO European Region now enjoy a life expectancy of 78 years on average, inequities in health exist in every country, she added. What is needed is action across 5 essential conditions that influence health equity, with policies and interventions built around accountability, policy coherence, empowerment and participation. The Health Equity Policy Tool developed as part of the initiative shows countries the 51 most effective measures for reducing health inequities and will help policy-makers to make informed decisions. Ms Brown underlined the widespread momentum supporting action, commenting, “The public are concerned about growing inequalities, and they want to see action”.

The subsequent panel discussion presented different ways of making the case for health equity across a range of constituencies, including emphasizing WHO’s 5-year global programme of work, mapping the gender equity gap, promoting the European Social Charter, bringing equity into all the SDGs and appealing to health professionals to address the social determinants of health. Asked how to ensure that doctors advocate for the social determinants of health, Professor Sir Michael Marmot, Director of the University College London Institute of Health Equity commented, “Doctors recognize that if people are getting sick through no fault of their own, but through social circumstances, that isn’t fair. They believe in social justice – appeal to this”. There was broad consensus among delegates that political choices and policies must be made with engagement from end users.

Parallel sessions

Four parallel sessions brought out rich discussions on universal health coverage, investing in living conditions, work and employment conditions, and income security and social protection. In sum, these sessions recognized the need for strengthening partnerships and harnessing interlinkages for health equity, the need for better and disaggregated data, that social value is as important as economic value and that simple innovations can have a big impact.

Achieve: creating the conditions and removing the barriers for all to prosper and flourish

This evening plenary session at the end of the first day began with an interactive poll, which asked the audience whether they agreed with the statement, “In my country, everyone has a chance to succeed in life”. Only 8% of the audience responded that they “totally agree” with the statement, echoing the findings of similar large-scale polls that have revealed strong public support for addressing health inequities.

Once again, panel members underlined the need to bring about a culture change that recognizes the social value of health equity. “We need a change of attitude, and a change in priorities. We must use political pressure to make health a priority across government – not just in speeches but backed with sufficient financing,” commented Ms Ilze Viņķele, Minister of Health of Latvia. Mr Vaughan Gething, Minister for Health and Social Services, Welsh Government, United Kingdom, summed up a common thread of the day’s discussions, concluding, “Changing people’s attitudes isn’t easy, but it is powerful. It’s about people understanding they are the biggest decision-makers in their own lives, but we stand beside them”.